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Day Lewis boss: We need better technology, not more GP pharmacists

Jay Patel: Relocating community pharmacists is a draconian measure
Jay Patel: Relocating community pharmacists is a draconian measure

Better use of technology could avoid the “draconian measure” of funding community pharmacists to work in GP surgeries, according to the Day Lewis executive director.

Jay Patel argued that “leveraging” the technology that already exists in community pharmacy, and giving pharmacists more say in the design of new systems, would help to “smooth the flow of information” between the sector and general practice.

This would make NHS England's £112 million investment in GP pharmacists unnecessary, he said.

Mr Patel was speaking during a presentation of his views on the future of community pharmacy at the Avicenna conference in Vietnam last week (October 24).

“If community pharmacy and general practice can work better in their current locations, there’s no need to have a drastic option [of relocating community pharmacists],” he told delegates. “That seems to me to be a draconian measure,” he said, adding: “there are other things we can do [instead].”

The other options Mr Patel argued for were Healthy Living Accreditation for pharmacies, which he said had “improved the quality and volume” of Day Lewis’ services, and means “it’s hard for doctors to see [pharmacies] negatively”.

Mr Patel also argued for more use of the technology that already exists in the sector, such as the Summary Care Record, electronic repeat dispensing, and a “connected” patient medication record.

“It’s quite an extreme decision to relocate community pharmacists,” he said. “We can use connected technology and leverage the existing infrastructure – this would smooth the flow of information between GPs and pharmacists.”

Better technology "within a year"

However he argued community pharmacists must be given “a seat at the table” when the systems that will be used in the sector are being designed.

“I believe that in the next six to 12 months there will be more and better tools to do our job.”

“Using technology means you can make your business more stable and provide an alternative to the more extreme scenarios that are mooted for the future of community pharmacy,” he added.

28 Comments
Question: 
Do you agree with Mr Patel's statements?

Din Patel, Manager

No, all GPs should employ a pharmacist to dispense all their prescriptions.
This was the practice has total responsibility and control over the drug budget including the dispensing costs. All profits go back to the practice for patient services. Surely, this makes sense. Pharmacists would be respected and better renumerated. They would not be expected to work for lower and lower rates by pharmacist employers. Better to work for doctors than a pharmacist.

Valentine Trodd, Community pharmacist

Nice jacket Jay.

Ronald Trump, Pharmaceutical Adviser

*Mr Patels views are Draconian and conceited. Ofcourse he is going to say having pharmacists in GP's is not going to work- because it doesn't fit in with his model and make him even richer. However, for the benefit of multidisciplinary and better patient care, having GP's, pharmacists, nurses, physios etc all working together in a single primary care setting, collaberatively, is a good thing. It is the natural evolution of a pharmacist's role and 21st century healthcare.

*This comment has been edited to comply with C+D's community principles*

Amit Patel, Senior Management

With all the talk of redeveloped services and value add, the reality is that whether GP or Community Pharmacy, we are mainly dealing with small business's and the acid test will be what happens when NHSE stop propping up these roles and the funding dies?  Will GP surgeries still be willing to take on the employment risk?

I still dont understand why communiyt pharmacists cannot be locumed in to run clinics at a GP surgery negating the risk and giving a boost both sides of the fence.

would that not be a better way to encourage working together?  I have heard nothing but positives where this is already happening.

I disagree, working in a GP practice I've found that practice staff aren't generally aware of what happens to a prescription once it has left the surgery, therefore implementing processes such as electronic repeat dispensing will only be successful if the process itself is actually fully understood. Ensuring that prescribing is safe and cost effective cannot be governed by technology but by an expert in medicine; a pharmacist. Personally, I think that having pharmacists in GP practice ensures that the patient journey is seamless.

Jay Badenhorst, Superintendent Pharmacist

You can educate without having to work there.

Paul Mayberry, Community pharmacist

https://www.england.nhs.uk/digitaltechnology/wp-content/uploads/sites/31/2015/06/electronic-repeat-dispensing-guidance.pdf

Job done!

 

Ilove Pharmacy, Non Pharmacist Branch Manager

 

What about 'dispensing robot'     Job done !

 

 

 

 

Paul Mayberry, Community pharmacist

Yes, exactly. There's nothing clever in dispensing. A technician should do it, a robot could do it, and an ACT could check it. You don't need a pharmacist to do it. What is needed is a pharmacist to clinically check rxs and to check with patients that they are getting the best from their medicines and aren't being harmed by them. Just 2 stages when a pharmacist adds value to the dispensing process. 

Once pharmacist are able to delegate or automate the dispensing process, they can do some of the fantastic work that Gerry is doing, but in the community, close to patients home, at times convenient to them and not in a GP surgery.

Angela Channing, Community pharmacist

The problem is Paul, the GPs want control, and they don't want it going out of house, they want it where they can see and control what happens to their patients, hence why Gerry is in the practice and not 'up the road' in your shop.

If Gerry reads this, could he tell us, please, what he thinks of working 'up the road' in a shop? How would he feel being in the pharmacy consulting room rather than in the surgery? Would the GPs be happy with that? Would it impact his work? 

Gerry Diamond, Primary care pharmacist

Jay Patel did not shed much light on what impact technology would make to delivering pharmaceutical care and the disadvantage of practice pharmacist per se. I ran a respiratory clinic, with spirometry, copd and asthma review and prescribed appropriately, full clinical review of medication, medicines management budgeting, QIPP projects and a minor illness clinics. and updating medication records, GP 2 GP patients transferys, reauthorisation of repeat preescriptions and dealing with queries from patients, GPs and district nurses. So when would a community retail pharmacist have the time to pop in and out of the chemist shop to sort all that out. No they would not have the time even with technology there is a lot of stuff that is face to face and hands on when working in a GP practice environment.

 

I think he is talking through his hat !!

Paul Mayberry, Community pharmacist

But why would you need to do that in a GP surgery Gerry?

 

Gerry Diamond, Primary care pharmacist

That is what the entails in a modern GP Practice, it is just not switching drugs to cheaper brands. I have done training in minor illness, respiratory and diabetes management  and spirometry. So part of the practice pharmacist role can and in my case involves running clinics. I have also completed IP training, Clinical Examination Skills and Clinical Diagnostics and Decision Making Skills. And also enployed as an Advanced Clinical Practitioner doing an advanced nurse practitiomer role. As the role develops so will the expertise and skill set of practice pharmacists in due course. Good luck !

Angela Channing, Community pharmacist

Good for you Gerry. And I bet you go home each night feeling much more fulfilled in your role than when you worked in a shop all day.  I wish all this had happened 20 yrs ago, I just feel too old and tired to engage now, and hope to coast to retirement over the next 5 to 10yrs. 

And shame on all the 'down votes'. There is absolutely no way GPs would allow any of this to take place in a community pharmacy with their patients run by Joe Bloggs pharmacist that the practice doesn't know.

We have been having all these discussions for the last 20 yrs. Anyone remember Ann Lewis and the PIANA initiative when she was President in the mid-90s?! Good that something is finally happening, and I'm sorry for Mr Patel, that it messes with his business model, but that's the direction of travel and all the community pharmacists on here need to find a way to engage with practice pharmacists, and I say this as just a regular old dispensing chemist bod!! They're obviously not going away, the government has decided to embrace them, so we need to work with them, not against them. Personally, I've always found them very helpful, and will sort stuff out for you much quicker than the receptionist or GP, mainly because they know what we are talking about, because alot of them still keep their hand in community. 

Paul Mayberry, Community pharmacist

Yes, exactly. There's nothing clever in dispensing. A technician should do it, a robot could do it, and an ACT could check it. You don't need a pharmacist to do it. What is needed is a pharmacist to clinically check rxs and to check with patients that they are getting the best from their medicines and aren't being harmed by them. Just 2 stages when a pharmacist adds value to the dispensing process. 

Once pharmacist are able to delegate or automate the dispensing process, they can do some of the fantastic work that Gerry is doing, but in the community, close to patients home, at times convenient to them and not in a GP surgery.Yes, exactly. There's nothing clever in dispensing. A technician should do it, a robot could do it, and an ACT could check it. You don't need a pharmacist to do it. What is needed is a pharmacist to clinically check rxs and to check with patients that they are getting the best from their medicines and aren't being harmed by them. Just 2 stages when a pharmacist adds value to the dispensing process. 

Ilove Pharmacy, Non Pharmacist Branch Manager

Really? And you're going to pay all these pharmacists. This sounds like the fairy tale about freeing up pharmacist so they can conduct mythical 'clinical services'

Kerry Banjo, Community pharmacist

i wouldnt say the everyday  comm. pharmacist conducts mythical clinical services- shows you dont think much of your staff - thats a big shame as pharmacists make a lot of worthwhile prescription interventions and give  sound pharmaceutical advice 

Jay Badenhorst, Superintendent Pharmacist

Is that not something that can be seen as a modern day community pharmacy? Btw, well done on all your qualifications.

Ilove Pharmacy, Non Pharmacist Branch Manager

Who will pay him his worth for that expertise ? Boots ? or you perhaps?

Ilove Pharmacy, Non Pharmacist Branch Manager

You're on different sides of the fence. I bet you have a few pharmacies and need some cheap pharmacists to maintain your profits. Gerry on the other hand probably considers quality of life, job satisfaction  and professionalism to be more important.

Ilove Pharmacy, Non Pharmacist Branch Manager

All those extra tasks you mention, I'm sure he'd quite happily add to the workload of his pharmacists. 

His only concern is profit. Don't fall for the rest of the guff.

Ilove Pharmacy, Non Pharmacist Branch Manager

Obviously he wants more low paid pharmacists to man his shop and maintain profits. 

lucas perez, Student

That's why big business loves free movement especially from the EU...the minimum wage has become the maximum wage. Over supply of labour means they can pay Low wages; anyone causing trouble by asking for more is easily replaced by another.... The top 5% of society are laughing while the others struggle ..

Angela Channing, Community pharmacist

One of the reasons I voted OUT!!  (waits for 'down votes' from employers!) 

Rubicon Mango, Academic pharmacist

There is an endgame agenda with this as I recently found out. Pharmacies which do not succumb to automation will remain, primarily in key areas. Town centres and gp surgeries. However a change in legislation will mean a technician will be in charge of the dispensary process. The pharmacist will be in the GP surgery clinically checking outgoing scripts so the clinical check has been done. Therefore the multiples can increase their profits and the NHS can continue cutting funding, the balance sheet still stacks, the result, mass unemployment for Pharmacists.

 

A former colleague left hospital to pursue an independent prescribers course, his dream as he stated. He was promised full time work on completion of his course. He of course works 2-3 days a week at the most now in a surgery an hour away. He is looking to get back into hospital because he cannot continue with the uncertain hours because he has a mortgage to pay. If the government had full intention on this, they would reduce the barriers of entry for pharmacists to prescribe and have fully funded models not with the view of gp's allocating resources, but bypassing that and directly placing pharmacists in clinics, surgeries, hospitals and wards. That is the endgame.

lucas perez, Student

 

 

Nothing to do with barriers....it's a supply demand ratio ....there are too many locums fighting for the little works that's available. 

 

 

 

Angela Channing, Community pharmacist

Yes, and badly paid too. Just been cut again from 20p/h to 19p/h.  I understand these are grim times for employers, but the global sum has been going up until last yr, but my wages have been frozen or cut for nearly a decade, so where has all that extra money gone?! In their pockets???! 

Head over to that studentroom website and all the 6th form lambs to the slaughter are busy comparing offers, and if they can get in with AAC! Why do none of them go and do any research on the current state of pharmacy, and in 5yrs time, they may not even get a pre-reg. Student numbers and pre-reg places is going to be the next bomb to blow up in pharmacy over the next 3 to 4 yrs. Very worrying when places like Nottingham are in clearing, 30 yrs ago, in the Telegraph (no net then!) only Sunderland or Leicester if you were lucky!! 

Ilove Pharmacy, Non Pharmacist Branch Manager

The LIES get bigger and more consistent.

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